05 June 2010

I wrote the other day about my general impressions after using the iPad for a month. But the device, shiny and lovely though it be, isn't much use without applications to flesh it out. Over the last few weeks, I have developed a pretty robust set of apps I use in my day-to-day life. Note that I am not at this time taking the iPad to work. There are a few reasons for that. First and foremost I worry that a mobile device like this will grow legs and walk away. The second reason is that our EMR does not have any ability to integrate with the iPad, and because I am at a workstation much of the day so I have access to the internet, references, and all sorts of medical tools on the computer, and the iPad doesn't add a ton to that, at least not with my current workflow. And not least, our IT system is locked down pretty tight, so my ability to bring in a new device onto the hospital network is nonexistent. Interestingly, I was told that Harborview has purchased 2,000 iPads. I will be very interested in seeing what they do with them.

So for now, I am using the iPad as a personal device, and these are the apps I have found most valuable. All links open in iTunes, BTW.

Productivity Tools:PagesApple's word processor. At launch time it was the only word processor available for the iPad, though I am sure that has changed. It's spendy -- $9.99 -- but worth it. The elegance and attention to detail are all you expect in an Apple product. I can make full-quality multimedia documents right there on the iPad. I am sure there are cheaper ways to do word processing on the iPad, but this is very nice and full-featured. The interface is rather different than Word, so it will take some relearning. Some of the conventions are weird and frustrating, others are so awesome you will wonder why they never did it this way in Word. I have not tried Keynote or Numbers yet.

DropboxThe iPad really doesn't have any sort of file management system, so you need something to get files onto the device. Dropbox is that tool. It's free, and basically a cloud host. You get a 2GB storage limit for the free account and can upgrade for a small premium. I'm still using the free account but it works so smoothly that I will almost certainly wind up upgrading eventually. The way it works is that you set up the desktop client and it creates a Dropbox file on your computer. Anything you put in there is synced to the cloud. You can have the client on multiple systems (say a home and work computer) and can access it on the internet as well. And of course anything you put there is accessible on the iPad, also. So you can throw your PDFs and word documents there for reading or editing later. You can also share folders. An ER doc reader offered me some interesting educational files (thanks!) and I just sent him a link to my dropbox and he threw them in there. My office manager wanted some PDFs and I sent her a link to the folder in my dropbox. It's great. My days of carrying around USB dongles or emailing large attachments are over.

EvernoteThis is a project management program which has morphed into my external brain. It's so powerful that I don't really know where to start. Create a note or web clipping or scan a document or an audio note or whatever you like -- there are all sorts of options to add content to Evernote. It also is a cloud computing service, and all your stuff is up there on the cloud. You can tag, sort and organize however you like. Images get automatic OCR done on them so they are also searchable. I have hundreds of recipes on mine, all the scanned menus from local take-out places, scans and meeting notes from work projects, a karate knowledge base and class records, a running list of blog drafts, and more. It synchronizes across multiple platforms (desktops, iPhone, iPad, and web) so you always have access. It's awesome. I got the premium service and will use it forever. I hear Bento is also nice but I'm committed to Evernote myself.

GoodReaderA great app for viewing PDFs, which is a necessity since I think the iPad cannot do this natively. It's $0.99, which is a rarity for such an essential app on the iPad. It does a lot more, allowing you to view doc files, read ebooks, view pictures, and the like.

1Password ProThis is a must-have app for anyone working in the hospital environment. How many logins do you have? Do you have to change them all every 90 days? I have about a dozen and most of them have all sorts of password restrictions. 1Password allows you to securely store them all for $6.99. (There's also a free version, which is not bad.) Better yet, if you spring for the desktop client, which is a little more expensive, it keeps them all synchronized across your desktop, iPad and iPhone. The desktop client integrates into your browser and can save passwords for web sites, and of course you can put your banking information there, too. There's a personal-information section too, where I keep my kids' social security numbers and other sensitive data. The encryption is ultra-strong, so you don't need to worry about security. Just don't forget your master password, or you're screwed!

News:New York TimesVisually just like reading the actual newspaper. Very nice. Does not give the full content of the actual paper, as apparently the NYT has a deal with the Kindle to provide exclusive content there. So it's a selection of the top articles, but let's be honest, they're the only ones you read anyway!

BBCThis is a beautiful, lovely app premised on the unlikely theory that newsworthy events occur outside of the United State. I love to open up the app and look at it, but the stories are all so ... foreign. Unsettling. I am not sure that the underlying premise is going to work. Still, sometimes they have stories about the US (like the oil spill) and funny stories about weird places like "Greece," which I assume is a fictional land cause nowhere real could be that messed up.

NPRAnother great, elegant news app. These folks all put a lot of thought into how news stories should be presented on the iPad. Their solutions all differ slightly, and it's a matter of taste which you prefer. But they are all excellent.

The Weather Channel MaxYou see, it's "max" because regular Weather Channel is not extreme enough. It is comprehensive and pretty to look at. I only wish you could set the preferences to start on the local weather page, because although the splash screen is pretty, it slows me down in an annoying fashion.

Blogs and social mediaFeeddler ProThis is an RSS client for your Google reader account. It's $4.99 and honestly, I am not sure I would buy it again. The app works fine and does exactly what's promised. Some people gripe about the bait-and-switch on the free version, which becomes crippled after one month. I can see being annoyed by that. I'm more of the mind that the app just doesn't seem to offer much advantage beyond the Google Reader interface in Safari. I've more or less stopped using it.

BlogPressAnother underwhelming app. It works with a variety of blogging platforms and allows simple text blog entries, and you can add photos. Whee. No text formatting, no hyperlinks (!!) and terrible customer support. For $2.99, it is not worth it. If there were a basic HTML editor, I would be entirely more positive about this app. I can email in a plain-text post to any of my blogs without paying anything. Sadly, there does not appear to be a good blog editor for the iPad (at least not one that works with Blogger).

FacebookThis makes me angry. Seriously, there's no excuse for the official Facebook app not to be iPad-optimized yet. I guess they're too busy trying to destroy their company with ill-considered privacy abuses. At least it's free. If anyone knows a Facebook client for iPad that doesn't suck, let me know.

TweetdeckThere are a lot of Twitter clients out there. I like this one best. It's free, easy on the eyes, and works well. Unfortunately it does not have the facebook integration that the desktop client does; I don't know why.

Miscellaneous EpicuriousAnother visually stunning app. This has tons and tons of recipes and the ability to suggest ones as well. You can put the iPad in a ziploc, prop it up in the kitchen, and use it as a guide while you cook. Also, you can have it email you a shopping list with the ingredients needed for a particular dish. Free and highly recommended.

NetflixKicks ass. Free, though you need an account. Watch streaming video instantly, manage your queue, etc. Online selection is not as robust as I would like.

ForeflightA great pilot's app. Plan your flight, get briefings, file your plan, get charts and maps, all on the iPad. While the app is free, the service is $75 a year. That might sound like a lot, but it's 30 minutes in a Cessna, and compared to the amount a Garmin or Jeppsen subscription will cost, it's a real bargain. I haven't been flying as much as I would like lately, but when I am next in the cockpit, this will be on my kneeboard. (They also make iPad-specific kneeboards.)

GamesX-PlaneI've been playing X-Plane on my mac for well over a decade. It's always been the best flight sim out there, and it's as good on the iPad. There is actually a whole family of X-Plane games: the regular game, X-Plane Trainer, Racing, Airliner, Carrier, Space Shuttle, Apollo and Extreme. The trainer game is free, and the Shuttle game is $1.99, the others are $9.99 each. The only complaint I have is that the apps are expensive enough that I would expect bigger maps, and would not think that you should have to pay multiple times for what amounts to different versions of the same game. The more traditional model would be to pay once for the game and a smaller fee for add-on maps/planes/scenarios. My favorite in terms of fun and replay value is the racing game, which lets you race a bunch of classic warbirds through windy canyons. I am not sure if these are iPad optimized, but you can't tell if they are not.

Flight Control HDBid farewell to many productive hours when you get this addictive little game. You try to direct multiple planes to the runways to land without crashing into one another. But there are different types of planes with different speeds, that can each only use particular runways, and they come from all directions. Fun and frustrating!

SnoodAnother classic mac game ported to the iPad. I actually don't play it much, but my seven-year-old loves it. $2.99 and always fun. Not iPad optimized but scales well.

tChessI think this is the best chess app for the iPhone/iPad. $7.99 but a lovely interface with lots of options. You can get hints, look at a library of openings, set up the board to play puzzles (my seven-year old loves this -- I make him do all sort of fun endgames), and the engine is tough enough that I have difficulty on the hard levels, but flexible enough that beginners can beat the easy levels. There may be tougher chess engines out there, but unless you are highly-rated you probably won't max out this one. And the customer support is great. Highly recommended.

SneeziesSilly, simple, fun and utterly utterly mesmerizing. Very cute. My five- and two-year-olds love this game, and I have spent more time playing it than I am prepared to admit. $0.99.

Monkey FlightA side-scrolling arcade-style game powered by (no joke) monkey farts. What's not to like? I have no idea where my wife found this one, but the kids love it and I do too.

If you can't tell, my kids have appropriated the iPad for their own use quite a bit, and I am not ashamed to use it as an electronic babysitter from time to time. The interface makes it simple for the youngest kid to use (though have some screen wipes standing by for sticky-finger residue) and there are actually about a dozen kid-appropriate games on my iPad that I'm not bothering to comment on. It's really great for casual gaming, and I certainly play more games on it than I do on my computer now.

Are there awesome programs that you use on your iPad that I didn't list? Let me know in the comments -- I'm always on the prowl for cool new apps.

I have to second your suggestion for 1 Password. I have the desktop version and it has proven to be something I simply can't live without.

I work at three different hospitals, some more frequently than others. Being able to store not only computer logins, but things like locker combinations helps me keep things straight. Especially if it's 2am and I've been up since 5am and even my muscle memory leads me to type in the wrong password.

It is not out for the iPad yet, but for the iPod, there is a tremendous EM Ultrasound app I just stumbled upon, called (curiously enough) EM Ultrasound. It has great instruction, along with pics and video of normals, and is shortly coming out with a ton of pathology I hear. Apparently these same people are working on an iEcho app too for EM docs.

I have Epocrates, MedCalc, MedScape, and TheWheel (a graphic classic OB wheel of misfortune calculator). There's also an app called eRoentgen which helps guide which radiology study to order. I am not a fan of Pepid, though it's available.

Also, you can get PDF versions of Rosens, Roberts & Hedges and Auerbach and use an e-reader like GoodReader to read them on your iPad.

I also have UpToDate bookmarked on my "med" screen, but it's not an app, just a quick-access to the excellent UpToDate service.

Also, EPIC has an iPad client called Haiku, which I don't have because we are not on Epic yet.

So IF you think an iPad can fit into your regular workflow, which it might in your case if your site supports Haiku, there are a lot of good apps and references for you.

I'm a researcher, not a physician, but I'm really enjoying Papers. It's a journal article reader/manager that can either stand alone or synch with a Mac desktop. It's an early version so there are still a lot of features to be desired, but it's been very helpful to have a growing library of PDF journal articles with me, grouped by subject and by author.

Shadowfax

About me: I am an ER physician and administrator living in the Pacific Northwest. I live with my wife and four kids. Various other interests include Shorin-ryu karate, general aviation, Irish music, Apple computers, and progressive politics. My kids do their best to ensure that I have little time to pursue these hobbies.

Disclaimer

This blog is for general discussion, education, entertainment and amusement. Nothing written here constitutes medical advice nor are any hypothetical cases discussed intended to be construed as medical advice. Please do not contact me with specific medical questions or concerns. All clinical cases on this blog are presented for educational or general interest purposes and every attempt has been made to ensure that patient confidentiality and HIPAA are respected. All cases are fictionalized, either in part or in whole, depending on how much I needed to embellish to make it a good story to protect patient privacy.

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